Professional Documents
Culture Documents
20
'.
\..
COMMUNITY
HEALTH
SURVEY
THE UNITED P.O. BOX 7 TULSA, TELE: CONTACT: Community Health Program Manager
STATES JAYCEES
OKLAHOMA
74102
(918) 584-2481
COMjl.1UNITYEALTH H
SURVEY
DETERMINING
COMMUNITY
NEEDS
Before your chapter can enter into a specific health project, you must first determine the most pressing health needs of the community. One means of determining the needs can be a survey of the community. Your health survey is a useful guide acquainting you with community efforts to keep pace with the health needs of its residents. In identifying health needs, it should also consider other important community factors which affect the degree of ease or difficulty with which your chapter will be confronted once you have established priorities and determined what programs you will undertake. Among these factors are: defining the nature or trends of the community, quality of leadership, quality of community effort to improve itself, identifying community leaders, problems and possible solutions, and priorities. Many community problems and needs are very obvious, and others may be more subtle. Therefore, a close scrutiny of the needs of your community is necessary to determine where your chapter can be most effective in their drive for better community health. If there are obvious problems that deserve the attention of Jaycee manpower, there is no need to waste valuable time to conduct and tabulate a survey that would only point up the same obvious problems. However, if community problems and areas of potential Jaycee involvement are not obvious, there are several types of surveys that the chapter can undertake to bring these needs into the open. WHAT STUDIES HAVE BEEN CONDUCTED? Before starting a survey within the community, check all other surveys that have been conducted locally in the health area so that you will be assured that your efforts are not duplications of similar projects. Health Councils or Commissions, Hospital Study Groups, City Planning Department, Chamber of Commerce, Health Department usually have on-going or completed studies. If studies are available, review them. Check with medical and health officials to determine if study objectives have been achieved or recommendations implemented. You might gain certain information from the U.S. Census of your community, but remember that census figures can be unreliable because they are gathered every ten years and can become outdated. The survey which follows is only a guide of areas to study, but the chapter committee might desire to add further questions
Community Page 2
Health
Survey
that would apply to your local community. Remember this survey is intended to aid you in identifying problems within your community, and opportunities for your Jaycee chapter to involve themselves in. It is designed to stimulage projects that can combat and eliminate those problems. The final results may depend upon judgment on the part of the chapter, and its evaluation of which community problems require the most immediate action. The following is a sample survey for obtaining information concerning the health problems in your community. This, by no means, covers every area nor will it fit every community setting, but rather serves are a guide in helping you develop a survey which will be pertinent to your situation. HEALTH 1. 2. PERSONNEL Are there programs community? for licensing LPN's ln your
How many physicians (M.D.) serve your community in private practice? In other capacities such as public health, institutions, industrial medicine, etc.? What medical specialists are available community, and in what numbers? ln your
3. 4.
Where do people in your community most often go for specialist services not available in the local community? How far away is it located? Is there a shortage of physicians in your community? If so, what has been done to attract more physicians? Is there a shortage of service in any particular medical specialty? Is the community large enough to support a specialist in this field? How many registered in your community? professional nurses are there Practical nurses? Midwives? for
5.
6.
7. 8.
HOSPITALS
9.
How many hospitals are located in your community? Of these, how many are general and how many are special purpose (mental, tuberculosis, and so on)?
Community Page 3
Health
Survey
10.
For each hospital, how many resident physicians and interns are one the staff? How many graduate nurses? Student nurses? What is their weekly schedule of hours on duty? Is there a social service Are rates adjusted patient? Is there a shortage community? department? to the income of the
11. 12.
according
13. 14.
of hospital service
beds
in your
is available?
15.
Do any hospitals refuse admission due to ethnic, racial background or financial status? If so, what alternative provision is made? Are facilities equal? SERVICES
Are current public health services reaching the disadvantaged of your community? If so, why not? (i.e., lack of transportation, uninformed of available services, attitude toward services offered, etc.) Are there branch public health clinics in various areas of your community? If not, would they be possible? What health programs have been designed for the "hard core poverty" citizens of your community in the last two years, if any? When was the last tax bond for the betterment of community health voted on in your community? What were the results? Did your chapter take a stand? Is there a local board of health? ted? What are its functions? What private organizations perform functions in your community? Do they work in frequent health officials? Is there a public water of this water? How is it selec-
17.
18.
19.
20.
public
health
consultation
with public
supply?
What
is the source
Community Page 4
Health
Survey
Have any illnesses in the past few years been attributed to the water supply? How often do collections place? of garbage and refuse take
Is this collection service available to all citizens of the community regardless of tax rolls, inability to pay for the service or other discrimination? What provision is there for inspection sewage disposal facilities? Have any local bathing of pollution? beaches of public because
been condemned
Are refuse and litter kept from accumulating in places where rat growth and breeding would be encouraged? Have city planners made provisions for the future disposal of increased garbage collection, and the coinciding problem of the community's growth? What is the infant mortality rate in your community? How does this rate differ in the socio-economic levels? What special mothers? health care is available for expectant How many
30.
31.
Is there a free prenatal clinic service? mothers make use of it in a year? What percentage of babies are born
in a hospital?
What special safeguards are there to assure adequate health care to unmarried mothers and their offspring? DISEASES tuber-
COMMUNICABLE 36.
37.
What mass x-ray or other mass screening devices are used to find new cases? Is it available to all citizens of the community? How many cases of venereal diseases were reported to health authorities in your community during each of the past five years? How many were teenagers?
38.
Community Page 5 Health Survey
39.
What epidemics have occurred within the past five years, and what measures were taken to control them? Is there a sex education program available in your local school system? If so, is it a mandatory course and what age group does it cover? What has been the community's reaction to such a program? How many unwed mothers were reported your local high school(s)? DISEASES How many cases of severe kidney diseases were reported in your community over the past two years? Is there an artificial kidney available in your community? (same for heart) machine last year ln
40.
41.
44. 45.
Is there a kidney donor program active in your community? Where is the nearest regional kidney center located? Insofar as such information is available, what is the extent of each of the following diseases in your community? Heart disease High blood pressure Arthritis Diabetes Multiple Sclerosis Venereal Disease Measles Cerebral Palsy Cancer Tuberculosis Polio
46.
What was the death rate from each of these diseases for the past five years? How many people from your community are participating in the state vocational rehabilitation program? Have any people been refused because of funds? rehabilitation services
What rehabilitation facilities are available to disabled veterans returning to your community? Where is your closest VA facility located? What provisions are there for those not receiving public assistance but who are medically indigent? What medical services are offered as part of the school program? to school children
50. 51.
Survey
clinics
Is there a sheltered workshop for the mentally retarded in your community? Special education classes? Have the local Boy Scouts ever worked with the mentally retarded children of your community? Does your state have adequate facilities for the retarded? What are admittance requirements (i.e., ethnic, racial, financial)? Has there been a public awareness program on mental retardation in your community (i.e., "they can be helped", etc.)? Are there employment programs for the mentally restored and mentally retarded? If so, how many businesses in your community participate? Are there special community recreation programs available for the retarded? Are they open to all retarded children of the community? Are the programs for the retarded the child and adult retardates? geared for both
54.
55.
56.
57.
58.
or state health
Are there counseling services or social casework services available in your community? Do the criminal courts avail themselves of clinical facilities for the mental examination of prisoners, particularly habitual offenders? Do other courts (family court, children's court) utilize the services of mental clinics or refer individuals to them where appropriate? To what extent does the public health department recognize mental health as part of its concern? What activities does it carryon in this respect? What associations in the community have mental health as one of their concerns? If there is no mental health organization in your community, is there a need for one?
63.
64.
Community Page 7
Health
Survey
65.
Is there a mental health clinic (psychiatric clinic) available in your community? If not, where is the nearest one? Does it serve both adults available and children? to all? Anonymous
Is this service
Is there any organization such as Alcoholics in your community? What are its activities?
How many people from your community are in mental hospitals at this time: Public? Private? Are there adequate fOllow-up services to discharged patients, including outpatient clinics and/or psychiatric social work service? EVALUATION Who are key business a. b. Name, and professional leaders?
COMMUNITY 71.
Present and past leaders of civic, business, professional and business organizations. of the economic to meed climate? the needs of
progressing
What are the community's assets? The attitudes of its residents? How would you rate municipal
Its liabilities?
department
performance?
Is there a pattern in which these community leaders generally unite or divide over community issues? How many of these leaders have or are directing their efforts toward community health needs? Does a common organization of this leadership? Is there any evidence solved key problems? exist that is representative wide action that
of community
80.
the community
as a
Community
Page 8
Health
Survey
81. 82.
List ten to twenty important community and/or problems and determine: a. b. c. Who is working to find solutions?
or sustaining
the
may be needed
to help find
; i t\ f i
'.
. s~x
,,
of
Interviewed
~lal:=: Female
1
2
1
2
3
4
5
6
(3)
Occupation
of Head
of Household
Professional Manager and/or ProprieLor Clencal Worker Sales Horker Crattsman or Foreman Farmer or Farm Worker SeL\1ice Horker Anj typ" Government Employee Un~mployed at present time
1
2
3
4
5
6
7
8
9
J t11er
10
(II)
Are
you
D.
home
O\\Tner?
1
2
3
4
1
2 3
4
1
2
3 4
5
6
7
(7)
How many
people
are in your
family?
I-One persor. 2-TvlO people 3-Three people 4-Four people 5-Five people
6-Six people j-Seven people 8-Elght people 9-Nine people lO-Ten people
C1J
Q')
c::
o
CI) C1J
A. '"'
o o
p..,
t::.::
C1J
c::
(1)
(8)
(2)
(3)
(4)
(5)
(6)
(7)
c:)ITl111unity's
1
1
1
(9)
Wnat is your OplnJ:)n or the storm water drainage system In )':)ur c.'Jrnmu:1ityi
;0;'
,'oJur
c'Jmrnunj.ty's
1
1
(12) How would YOJ rate you~ ~oDm~nity's 10.::a1 televisIon & radIo programming? (13) How wOilld you rare in your co~nunity! the tIce prote:tlon
(14) How w:)uld yo~ ra:e law en!:)rcement & polIce protectIon In your c:)mmunity?
1
1
1
In your
1 1 1
1
medical
(19) Would you rate your comr:1U,ll I S medIcal ty services adequa te in quah ty?
services
J.J::.a~ 2 the 4-H, youfor t thinkCILizens5lZctasslstan:e, 1 2 Wouldw:>uldyou.inyouth 1y. your1ncom3 Whatthe u;o:port;"lion locali health toDoescommunJ.ty in fl'-:: lhon servln~ 1n 1 ./ 5 e[c.)]nIncons:derratec~m:nunlty'sser~ices 4 com-y~~ Guyou allyoulhIJ'.lb11Cest the J'J Whatco~~unl:! e::c. malntEn~n:e ( t opinio~ 6 GiveaI-:Jarea ~n g.y~urpa:~jGg r 7 is your q~lant1ty?~Uall[>',-ng ty.a;,n::'1e,; of , qual:ty! Boy yo~r 1jratem~e. ,)'.15 10C31 .~ availablilcy ade~~ate your opinion denLal jOu>: ~~mmu~lty! )" Sidewalks ~h~ Are would:.a,::e on r:,ads, the Ji:l2, Do you consider !-OCo;t::C: :,e:1recreational Give Op1nJJ~ lL:rw youropinlonthe is d:> loplnlonyour of y:)ume,:: rate quantI health :.;ouroplnion G1ve &your c~mmunity's How op1n10n :..r ~trec:s,hou51og (21) famlliesja~{J. th~ir[heon6L!i2.r.aJ.a~en=lEs In
6 3 5
c~XntnUlll
(e p.;b~~0: t ~
I 1
ic~ needs localiin comr.:un:t)' 1n In qUbllty cat10nal opportunities quali:y: y~ur oi services!y~urty ade:]uate in maintenance them81ntenance in the munity's area starf? r:y:' the corr:r.:uni prograr.J? ~ty their ty. inadwquat tlvites? depart~ent presch~ol prcgram qua ~f adequate
11
&1 1
(38~
1 1
it
2 2
3 3
4 4
5 5
6 6
7 7
"-- (39)
(40)
\\Thar IS vour opl.nl0n of YOU( ('ommunitv's elementary scho~l edc:ational program? . What IS yO'Jr opil)lon munity's elementary and equipment?
\\That is your
(41)
(42)
opInion
munlty's (43)
]"dnl.or
hi~J1
se]H',,] SliJ[t?
\!hat is your opinion of your ::::}I,,raunity's JunJor 11lgh s:);::,oJ.. educa.tional pro~ra8? What 15 your opin1oG of j0Ur c~mmUlll ty 's j u:-:ior hJ g~1 ':;0:.11:::01 b ul.ldingandequlpment? \,'hat: lS your OjnnlOn munity's senior hlgh What 15 your Oplnl.~n munity's senior hlgh tional pH)i;ram, of yoclr c.om5chool staff? 01 your comschool educa-
2:
(44)
(45)
(46)
{,
(47)
h'hat IS your opinl:!n of your communlty's senl0r high 5:hool buildin and equlprnent? How would you late parent pation in school actl.Vitles? Ho\\' do prices compare wlth comrnunities? partici-
1 1
2 2
3 3
4 4
5 5
6 6
7
7
(48)
(49)
(50)
HO\\' does the quality of merchandise in your cOr:'_"11unJ'-ty ompare with other c neigbboring co:mnuni ues? How do real estate c:>sts in your communi ty compare \\'i th nelghbor Ing CO!:l!:Iuni ties? How do bank facilit1cs munities compare wlth bori:1g communi tl es? in your comother n21gh-
(51)
(52)
" 2 2 ~lal t to tht.;reprogramsundercC!b comfo~ opInion for opi 4 Whart is feed COJ'Tl-eno\.Jgll om6 Do 3 VIha 1S 25? are ni::m 1 dnd pe:J?le1 com7 VIhat i[;opInionplC~lC3 t8 Hha vou65fee]over? ot arc ofshould job 6 Do36 IS think there 5 chi j 4 Whattis there 35youienough ldren? 50? to 1 5 \-ihelis fct:;Jpeople your enough 4 peopleparksyom-64? :)r 26 andyour 51 opinion to & for an~ for cOQ~unity opip-ion Yo'Jr Jab oplnlon yo~r job co~comyour are (53)- Wha you18feelcom- of areareaslfor J::>b Dc opinion 11tles? (61) l ervices! oppor tuni ngsold? es? public meetingties s: rtunities Opportunities y's placesopportunitIes places n rtu!uties ml'rnty 's culturalg fa C.llllles '! rtunitics ~unity's s'.nm;rd public r
1 1 1 1 Yes Haybe 1
(69)
Do you feel your c8m~unity sh~uld develop a wider range of services for its citizens mlich of the general areas 11sted \rlou1dmost improve your c::>:TImuni ty in your opin10n? (Pick ::>n1y ons)
Yes Maybe No
1
2
(70)
Police Health Streets, roads, trafficways. and their maintenance Traffic control & parking Parks and recreation Planning and Zoning New Public construction New private industry Improved local government Hoapitals
1
2
3
4
5
6
7
8
9
10
(71)
\,Thichof the general areas listed would most improve your COTI1!lIUn1 ty in yeur opiniop? (?lck only one)
1
2
3
4 5
(72)
1
2
Maybe No N.:>t sure. Yes Maybe Not presently At a future date No Yes Maybe Not presently At a future date
No
3
4
(73)
Would you be wililng to accept a greater tax load for a community improvement you ap~rove:
I
2
3
4
(74)
\]ould you assist c;:JilljTIunity l.mprovement effurts with your tl.me and work? (not money)
I
2
3
4
(75)
If you are interested 1n ass1sting a communi ty ii:lprove:::en general develt & opment effort, do you think your friends would also be w1ll1ng to assist? Have you ever belinged to any group or organization 1nterested in 1mproving the co::.muniy? t Would you attend a meeting aimed at bringing about community improvement?
Yes Haybe No
I
2
(76)
Yes
I am not aware No
Yes
of any such
group
I 2
3
(77)
I
2 but later
t-laybe Not at present, No Excellent Good Average Below average Poor No response
3
4
(78)
1
2
of your
ca~~unity?
3
4
5
6
6. 7. 8.
9.
10.
runway lighting, adequate physical buildings? Is there a need to consider a relief of congestion at your airport? Are state requirements for boating registrations fairly rigid? Is there a current project underway, if you are near water, to reduce accidents in or near water? (i.e., capsizing, boat collisions, disregard for preservers) Are there any general home-industry projects in your community to spotlight preventive safety? (i.e., in grade schools, businesses employing large numbers) Is public safety encouraged in any manner in your city?
5.
6.
7. 8.
I s there a shortage of physicians in your community? If so, what has been done to attract more physicians? Is there a shortage of service in any particular medical specialty? Is the community large enough to support a specialist in this field? How many registered professional nurses are there in your community? Practical nurses?Midwives? Is there a shortage of nurses available for hospital service? Private duty?
Hospitals 9. How many hospitals are. located in your community? Of these, how many are general? How many are special purpose (mental tuberculosis, and so on)? For each hospital, how many resident physicians and interns are on the staff? How many graduate nurses? Student nurses? What is their weekly schedule of hours on duty? Is there a social service department? Are rates adjusted according to the inoome of the patient? Is there a shortage of hospital beds in your oommunity? What kind of ambulance service is available? How is it paid for? Do any hospitals refuse admission due to ethnic, racial background or financial status? If so, what alternative provision is made? Are facilities equal?
10.
11. 12. 13. 14. The following is a sample survey for obtaining information concerning the health problems in your community. This, by no means, covers every area nor will it fit every community setting, but rather serves as a guide in helping you develop a survey which will be pertinent to your situation. This survey was developed with the com~ined experiences of U. S. Jaycees Directors in the Health Subcommittee at the March, 1969, Board of Directors Meeting. Health Personnel 17. 1. 2. Are there programs for licensing for LPN's in your community? How many physicians (M.D.) serve your community in private practice? In other capacities such as public health, institutions, industrial medicine, and so on? What medical specialists are available in your community, and in what numbers? Where do people in your community most often go for specialist services not available in the local community? How far away is it located? 15.
HEALTH
Public Health Services 16. Are current publ ic health services reaching the disadvantaged of your community? If not, why not? (i.e., lack of transportation, uninformed 'Jf available services, attitude toward services offered, etc.) Are there branch public health clinics in various areas of your community? If not, would they be possible? What health programs have been designed for the "hard core poverty" citizens of your community in the last two years, if any? When was the last tax bond for the betterment of community health voted on in your community? What were the results? Did your chapter take a stand? Is there a local board of health? How is it selected, and what are its functions?
18.
19.
3. 4.
I,
20.
30.
31.
What private organizations perform' public health functions in your community? Do they work in frequent consultation with public health officials? Is there a public water supply? What is the source of this water? Have any illnesses in the past few years been attributed to the water supply? How often do collections of garbage and refuse take place? Is this collection service available to all citizens of the community regardless of tax rolls, inability to pay for the service or other discrimination? What provision is there for inspection of public sewagedisposal facilities? Have any local bathing beaches been condemned becauseof pollution? Are refuse and litter kept from accumulating in places where rat growth and breeding would be encouraged? Have city planners made provisions for the future disposal of increased garbage collection, and the coinciding problem of the community's growth? What is the infant mortality rate in your community? How does this rate differ in the socia-economic levels? What special health care is available to expectant mothers? Is there a free prenatal clinic service? How many mothers make use of it in a year? What percentage of babies are born in a hospital? What special safeguards are there to assure adequate hea Ith care to unmarried mothers and their offspring?
40.
41.
Is there a sex education program available in your local school system? If so, is it a mandatory course and what age group does it c.over?What has been the community's reaction to such a program? How many unwed mothers were reported last year in your local high school?
Chronic Diseases 42. How many cases of severe kidney diseases were reported in your <:ommunity over the past two years? Is there an artificiai kidney (same for heart) machine available in your community? Is there a kidney donor program active in your community? Where is the nearest regional kidney center located? Insofar as such information is available, what is the extent of each of the following diseases in your community? Heart disease Cerebral palsy High blood pressure Cancer Arthritis Tuberculosis Diabetes Poliomyelitis Multiple sclerosis What was the death rate from each of these diseases for the past five years? How many people from your community are participating in the state vocational rehabilitation program? Have any people been refused rehabilitation services because of funds? What rehabilitation facilities are available to disabled veterans returning to your community? Where is your closest VA facility located? What provisions are there for those not receiving public assistancebut who are medically indigent? What medical services are offered to school children as part of the school program? Are immunization clinics held at the school?
43. 44.
45.
46. 47.
48. 49.
Communicable Diseases 36. 37. What is the known number of cases of active tuberculosis in your community? What mass x-ray or other massscreening devices are used to find new cases?Is it available to all citizens of the community? How many casesof venereal diseaseswere reported to health authorities in your community during each of the past five years? How many were teenagers? What epidemics have occurred within the past five years, and what measures were taken to control them?
Mental Health
38.
53.
39.
54. 55.
Is there a sheltered workshop for the mentally retarded in your community? Special education classes? Have the local Boy Scouts ever worked with the mentally retarded children of your community? Does your state have adequate facilities for the
26
56.
57.
58.
63.
64.
retarded? What are admittance requirements (Le., ethnic, racial, financial)? Has there been a public awareness program on mental retardation in your community (i.e., "they can be helped", etc.)? Are there employment programs for the mentally restored and mentally retarded? If SU, how many businessesin your community participate? Are there special community recreation programs available for the retarded? Are they open to all retarded children of the community? Are the programs for the retarded geared for both the child and adult retardates? Does your community observe national or state health weeks? Mental health week? Are there counseling services or social casework servicesavailable in your community. Do the criminal courts avail themselves of clinical facilities for the mental examination of prisoners, particularly habitual offenders? Do other courts (family court, children's court) utilize the services of mental clinics or refer individuals to them where appropriate? To what extent does the public health department recognize mental health as part of its concern? What activities does it carryon in this respect? What associations in the community have mental health as one of their concerns? If there is no mental health organization in your community, is there a need for one? Is there a mental health clinic (psychiatric clinic) available in your community? If not, where is the nearest one?
ESTABLISHING PRIORITIES When a health survey has been completed, it's time to evaluate the findings of the survey, determine which problem areas should be tackled first, and match the resources of the chapter and the community to the problem areas. Members of the committee or the Board of Directors should take a close look at the findings of the survey, and then a discussion of the problems should follow. This discussion should not merely rely on the judgment of Jaycees, but also on the judgment of other groups, including the target area citizens. After each man feels that the problems have been properly identified, each can list in 1: 2,3, order the top priority programs.
COMMUNITY RELATIONS The needs and methods of conducting Community Relations projects will differ from city to city. It would be impossible for one manual to determine the programming of all local Jaycee chapters. It is for this reason that you must determine your own needs and your own methods of conducting Community Relations projects. One means of determining what community relations projects are needed in your community is a survey - a survey of the public that will determine your status within the community. See what areas you need to work in for better Community Relations. Your survey may take on many forms. You can survey selected persons within your community, such as: the city and county officials, and attend other organizations' meetings to find out how they view your Jaycee chapter. Conduct a telephone survey and ask how the public feels toward Jaycees in your community. To determine what projects need to be planned in your area, first make a list of possible Community Relations projects (a number of suggested projects are listed later in' the manual), then see if any of these projects are now being conducted within the community. If they are being conducted, determine whether you can help to make them more successful. If you can help, don't make the mistake of going in and taking over. This
65.
69.
70.
27
()v ,L".)\
'~ ~~
, .x Y~~V~ 4'
I~~' C ~
I.JA
(Yo'
is ver~ simple.
of Virginia Centers
is a series
of Information
Referral
\'lay.
That's
right,
is one number
The service
24 hours by simply
no matter where you live or work free number The~ in your area. and Referral receive help.
Information
Centers your
have
staffs
of professionally minutes,
trained
You will
nave
~amily
emergency
food assistance,
emergency
financial
job training,
legal aid,
assistance,
Also,
the problems
your chapter
does it.
work
and averages
are needed,
so also you can call these numeers and needs in your community but
problems
~ ~
:..
,..
:--' .---
<
Page
2 of COMMUNITY
HEALTH
Where
do I go to find Help?
your
services.
needs
your
at the numbers
below will be
the spot that is best and most meaningful to Cee$ in your Chapter? But what's io be gained by the Jay~ to utilize special knowledge and
and useful,
get involved
in activities sil}nificance,
community
or national
gain a sense of
from feeling
AND REFERRAL
CENTERS AREAS
IN VIRGINIA
SERVED
Arlington ,Alexandria
Charlottesville Fairfax
(804) 296-2116
Harrisonburg(703) Loudon
& Harrisonburg
&
Bedford,
Campbell,
(703) 382-6478
Montgomery
...
-.
Page 3 of COMMUNITY
HEALTH
WHERE
DO I GO TO FIND HELP:
~-s:
....
,-
Newprot Norfolk
News(804)
838-9770
Hampton,&
(804) 625-4543
Norfolk, Chesapeake, Virginia Beach, Portsmouth, Franklin, Suffolk, Newport News, Hampton, Williamsburg, Jork Co., Accomac, Isle of Wright, Poquoson Co., & South Hampton Co. Dinwiddie, Greenville, Sussex, Prince George, Hopewell, & Petersburg Manassas and Manassas Surry, Emporia, Park
Petersburg
(804) 526-6179
(703) 368-8157
or
361-4131 (804) 353 -1201 or 353-1277 Charles City, Chesterfield, Goochland, Hanover, Henrico, New Kent, Powhatan & Richmond Allegaany, Botetourt, Craig, Roanoke, Salem, Clifton Forge, & Covington Bath, Rockbridge & Highland
:r.:.:
/'
Richmond
Roanoke
(703) 345-7351
Staunton(703) 885-4670 WaynesboroAugusta Co. Area Washington County Submitted Virginl~ (703) 944-5932
Washington
County
Program
Manager
for Community
Health
15, 1978
~.
VIRGINIA JAYCEES
"BEST COM"1UNI TY HEALTH PROJECT OF TdE QUARTER"
Entry Fonn
.. .
CHAPTE R P RES I DENT PROJECT NAME OF CHAl R:-1A.~ PROJECT
On the back of this page only, and its impact on your chapter
THIS BEST
IS OF
TO
CERTI
FY THAT
-iHE I;~FOR;~1\TIOiI
Oil
iliIS
ENTRY
IS
TRUE
TO
THE
PROJECT
PRES I DENT
Hinners overall
Health
Program
Convention,